Provider Demographics
NPI:1497392021
Name:ESSENTIAL CONNECTIONS CONSULTING & WELLNESS SERVICES LLC
Entity Type:Organization
Organization Name:ESSENTIAL CONNECTIONS CONSULTING & WELLNESS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NIESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:910-632-0011
Mailing Address - Street 1:PO BOX 231
Mailing Address - Street 2:
Mailing Address - City:SUPPLY
Mailing Address - State:NC
Mailing Address - Zip Code:28462-0231
Mailing Address - Country:US
Mailing Address - Phone:910-632-0011
Mailing Address - Fax:
Practice Address - Street 1:177 STONE CHIMNEY RD SW
Practice Address - Street 2:
Practice Address - City:SUPPLY
Practice Address - State:NC
Practice Address - Zip Code:28462-3377
Practice Address - Country:US
Practice Address - Phone:704-723-1571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty